• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.68-72
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• 2022

Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-year-old man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.

• Biomaterials and Biomechanics in Bioengineering
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• v.3 no.2
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• pp.71-84
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• 2016

The finite element method is wide used in simulation in the biomechanical structures, but a lack of studies concerning finite element mesh quality in biomechanics is a reality. The present study intends to analyze the importance of the mesh quality in the finite element model results from humeral structure. A sensitivity analysis of finite element models (FEM) is presented for the humeral bone and cartilage structures. The geometry of bone and cartilage was acquired from CT scan and geometry reconstructed. The study includes 54 models from same bone geometry, with different mesh densities, constructed with tetrahedral linear elements. A finite element simulation representing the glenohumeral-joint reaction force applied on the humerus during $90^{\circ}$ abduction, with external load as the critical condition. Results from the finite element models suggest a mesh with 1.5 mm, 0.8 mm and 0.6 mm as suitable mesh sizes for cortical bone, trabecular bone and humeral cartilage, respectively. Relatively to the higher minimum principal strains are located at the proximal humerus diaphysis, and its highest value is found at the trabecular bone neck. The present study indicates the minimum mesh size in the finite element analyses in humeral structure. The cortical and trabecular bone, as well as cartilage, may not be correctly represented by meshes of the same size. The strain results presented the critical regions during the $90^{\circ}$ abduction.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.223-228
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• 2016

Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

• Journal of Bone Metabolism
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• v.22 no.1
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• pp.17-21
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• 2015

Background: There has been lack of epidemiology of proximal humerus fracture using nationwide database in Asia. The purpose of this study was to investigate the incidence of proximal humerus fracture and its mortality following proximal humerus fracture in Korean over 50 years of age. Methods: The Korean National Health Insurance data were evaluated to determine the incidence and mortality of proximal humerus fracture aged 50 years or older from 2008 through 2012. Results: Proximal humerus fracture increased by 40.5% over 5 year of study. The incidence of fracture increased from 104.7/100,000 in 2008 to 124.7/100,000 in 2012 in women and from 45.3/100,000 in 2008 to 52.0/100,000 in 2012 in men, respectively. One year mortality rate after proximal humerus fracture was 8.0% in 2008 and 7.0% in 2012. One year mortality rate were 10.8% for men and 7.0% for women in 2008 and 8.5% for men and 6.4% for women in 2012. Conclusions: Our study showed that the proximal humerus fracture in elderly was recently increasing and associated with high mortality in Korea. Considering proximal humerus fracture was associated with an increased risk of associated fractures and an increased mortality risk, public health strategy to prevent the proximal humerus fracture in elderly will be mandatory.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.345-350
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• 2003

We were preferred bovine cortical bone to the others in xenobonegrafts for human and small animals, because those were not limited to supply and have sufficient size for bone transplantation. The strength (ST) and stiffness (SF) of cortical bone in bone grafts were very important. The strength and stiffness of cortical bone were much difference according to position of long bone in bovine limbs because which were biomechanical different to bear body weight. Therefore, we determinated by three bending point test methods the strength and stiffness of cortical bone which were collected in diaphysis of humerus, radius, femur and tibia of bovine. In the results, the strengths and stiffness among these were highest in radius by ST: 253.84$\pm$40.80 MPa, SF: 7.89$\pm$1.91 Gpa and lowest in humerus by ST: 185.69$\pm$28.54 MPa, SF: 6.21$\pm$1.22 Gpa.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.63-63
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• 2006

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.137-142
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• 2012

Purpose: To report the clinical and radiological result of the vascularized fibular epiphyseal transplantation in the treatment of humeral head deformity by septic arthritis Material & Methods: A 3 years old male who has humeral head deformity and bone defect by septic arthritis on neonatal period. We replaced bone defect as vascularized fibular epiphyseal transplantation and lengthened humerus shaft for humerus discrepancy. We followed it up for 14 years. Result: We saw the callus formation 2 months after surgery and obtained bone union, one year after surgery. The transplanted fibular bone got hypertrophy. We could check full range of motion on lt. shoulder and The bone deformity was not worsened and The graft did not displaced on last follow up. Conclusion: Humeral head reconstruction by vascularized fibular epiphyseal transplantation showed good clinical outcome.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.84-90
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• 2021

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.87-90
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• 2011

Osteoblastoma is rare, benign, bone-forming tumor that often occur in the spine. There are few reports of osteoblastomas resulting in pathologic fractures involving long bones. Authos report a unique case of a pathologic fracture due to an osteoblastoma of the humerus shaft. The tumor was treated successfully by curettage, intramedullary nailing and bone allograft.

• Journal of the Korea Convergence Society
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• v.8 no.11
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• pp.115-121
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• 2017

The present study aimed to obtain basic knowledge of a customized artificial joint based on the convergence research of Digital Imaging and Communications in Medicine(DICOM) and 5-axis machining technology. In the case of the research method, three-dimensional modeling was generated based on the medical image of the humerus bone, and the shape was machined using a chemical wood material. Then, the anatomical characteristics and the modeling machining computation times were compared. The results showed that the Stereolithography (STL) modeling required twice more time for semi-finishing and 10 times more time for finishing compared to the Initial Graphics Exchange Specification(IGES) modeling. For the 5-axis machining humerus bone, the anatomical structures of the anatomic neck, greater tubercle, lesser tubercle, and intertubercular groove were similar to those in the three-dimensional medical image. In the future, the convergence machining technology, where 5-axis machining of various structures(e.g., the surgical neck undercut of the humerus bone) is performed as described above, can be efficiently applied to the manufacture of a customized joint that pursues the precise model of a human body.